Jadhav Flashcards
Non selective COX inhibitors
NSAIDS - Aspirin & ibuprofen
Aspirin
NSAID (non selective COX-Inh.) irreversibly binds Cox I & II. inhibits pain in peripheral and CNS. Can cause GI EFECTS , decreased BLOOD COAGULATION, and decreased RENAL BLOOD FLOW (due to vasoconstrictors).
COX II inhibitor
Rofecoxib
Rofecoxib
NSAID selective COX II inhibitor. does NOT alter mucosal defence or platelet aggregation. BUT can cause Increased CLOTS and MI. TBX-A2 isn’t reduced which increases PLATELET STICKINESS. [withdrawn]
Acetaminophen
Tylenol; lacks anti-inflammatory actions. Less GI stress than Aspirin. HEPATOTOXIC (10mg) Antedote: N-acetylcysteine. * NO PERIPHERAL COX INHIBITION. Strong Analgesic (pain reliever) & Antipyretic (fever)
Neuropathic pain
injury to peripheral or central SENSORY nerves. Hyperalgesia Allodynia Paresthesias Dyesthesias *DIFFERENT from nociceptive pain.
Nociceptive pain
caused by TISSUE DAMAGE releasing chemical pain mediators.
Hyperalgesia
increased pain evoked by noxious stimulus
Allodynia
pain caused by stimuli that are not normally painful. eg. touch, bed clothes, wind
Paresthesias
tingling, pins and needles, burning sensation
Dyesthesias
burning, shooting, electric shock-like sensation.
Fibromyalgia
chronic diffuse pain (18 tender point*)
CENTRAL SENSITIZATION
depression, fatigue, sleepy
Treated with anticonvulsant (pregabalin)
Gout
inflammatory join disease caused by incread uric acid in blood. Precipitates where temperature is lower (toes/ distal joints) Crystals attract leukocytes and increase inflammatory mediators. (joint damage)
Treated with NSAIDs and CORTICOSTEROIDS(prednisone) . Also with CHOLCHICINE. all decrease inflammation.
Migrane Headaches
Common & Classic Migraine: with Aura - fully reversibly sensory symptoms: visual, olfactory, difficulty of speech for 5-60 mins.
Treated with NSAIDS and TRIPTANS(Sumatriptan- seritonin agonist). NOT USED IN PREGNANCY AND CV DISEASE.
ERGOT derivatives - cause vasoconstriction (NO in CV) can cause retroperitoneal fibrosis (URETERAL Obstruction)
Migraine Prophylaxis
has to be more than 15days / month
Beta blockers, tricyclic antidepresents , Calcium channel blocker, Antieplieptics
Fomeprizole
treats Methanol toxicity. (poisoning)
Ethylene glycol
anti freeze ; causes ACUTE RENAL FAILURE. Can be treated with Ethanol and Fomepizole.
Major depression
TCAs, SSRIs, SNRIs, atypical Antidepressants
*Noradrenergic systems are inhibited.
Two types of Depression
Major and Bipolar depression
MAOIs (Monoamine Oxidase Inhibitors)
Tranylcypromine - irreversibly binds to MAO blocks MAOa & MAO B.
Moclobemide - reversibly binds to MAO-A. doesn’t alter MAO-B in the liver. (cheese and wine isn’t a problem)
SNRIs (serotonin/norepinephrine reuptake inhibitors)
Includes: Atypicals & MAOIs. no affinity for any neurotransmitter receptors
Fewer adverse affects . DISCONTINUATION SYNDROME
TCAs (Tricyclic antidepressants)
BLOCK serotonergic , a-adrenergic, histamine, and muscarinic receptors. NON SELECTIVE . Imipramine was first. 3 ring structure [*CLASSIFIED by structure]
*IPRAMINES & TRIPTYLINES
NSRI (Non-selective reuptake inhibitors)
BLOCKS serotonin and Norepinephrine reuptake.
Atypical Antidepressants
l
Dysthymia
experience sadness
Perinatal depression
depression surrounding childbirth.
Parkinson’s disease
Treated with Dopamine stimulation and muscarinic receptor antagonists.
Psychotic disorters (Schizophrenia)
Treated by blocking Dopamine systems and inhibition of Serotonin systems.
Alzheimers
Treated by acetylcholinesterase inhibitors,
SSRIs (Serotonin selective reuptake inhibitors)
more block of Serotonin.
